NCNDA is between Patriot Health's Facilitator & Buyer Mandate NCNDA Request Form NCNDA "*" indicates required fields Company Name making the purchase Does your buyer already have an ICPO reference number for this order? Please help us identify the company above and the state where they are registered.*You could also give us the link to the buyer's business website or use one of these search engines -- https://www.bbb.org/search https://www.dnb.com/duns-number/lookup.htmlName of the BUYER who will sign the SPA. Need the FULL name of a Person* Buyer's Email* Buyer's Phone number Product Name* Lot Size* Order Size (consider rolls and extensions)Target Price per Box* Buyer Mandate Name* Buyer Mandate Email* Buyer Mandate Phone Number Who is filling out this form?* First Last I have authorization from the buyer listed above to request this NCNDA* I agreeWhat is your role with this buyer?* We want to send you a return email outlining next steps.* Extra information about this NCNDA requestWe do our best to produce a clean NCNDA which we define as a short broker chain. We recommend that the NCNDA only have a few key buyer intermediaries outside the buyer, seller and mandates. Think of it this way, on the IMFPA there will only be a few intermediaries representing groups of intermediaries getting paid via a sub-fee. Please attempt to only have those key people on the NCNDA.We prefer only two more buyer intermediaries.*Buyer Intermediary Name, their Email and Phone (optional)Buyer Intermediary Name, their Email and Phone (optional)Buyer Intermediary Name, their Email and Phone (optional)Does this group have a supplemental NCNDA already in place? Please upload it here.Max. file size: 1 MB. Δ
